From the Guidelines
Cervical Radiculopathy Without Focal Neck Pain
Yes, a patient can have cervical radiculopathy without focal neck pain. Cervical radiculopathy is defined as a syndrome of pain or sensorimotor deficits due to dysfunction of a cervical spinal nerve, the roots of the nerve, or both 1. The most common clinical presentation is a combination of neck pain with pain in one arm accompanied by varying degrees of sensory or motor function loss in the affected nerve-root distribution, but it is possible for patients to present without significant neck pain 1.
- Key symptoms of cervical radiculopathy include numbness, tingling, and weakness in the arm or hand, which can occur with or without neck pain.
- A thorough physical examination and diagnostic tests such as electromyography (EMG) or magnetic resonance imaging (MRI) may be necessary to confirm the diagnosis, especially in the absence of focal neck pain 1.
- Treatment may include medications such as gabapentin or pregabalin to manage symptoms, as well as physical therapy and lifestyle modifications to alleviate pressure on the affected nerve root.
- It's worth noting that most cases of acute cervical neck pain with radicular symptoms resolve spontaneously or with conservative treatment measures 1, highlighting the importance of a thorough evaluation to determine the best course of treatment.
From the Research
Cervical Radiculopathy Without Focal Neck Pain
- Cervical radiculopathy is defined as a syndrome of pain and/or sensorimotor deficits due to compression of a cervical nerve root 2.
- The clinical consequence of radiculopathy is arm pain or paresthesias in the dermatomal distribution of the affected nerve and may or may not be associated with neck pain and motor weakness 2.
- Cervical radiculopathy describes pain in one or both of the upper extremities, often in the setting of neck pain, secondary to compression or irritation of nerve roots in the cervical spine, but it can occur without neck pain 3.
- A patient can have cervical radiculopathy without focal neck pain, as the condition is characterized by pain and/or sensorimotor deficits in the affected nerve root, which may not always include neck pain 4, 5, 6.
- The diagnosis of cervical radiculopathy is guided by history, physical exam, imaging, and electrophysiology, and patient history and clinical examination are important for diagnosis, regardless of the presence of neck pain 2, 3.